ZOLOFRA INSURANCE AGENCY

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Restaurants

*Contact Name *Name of Business *Address *City, State & Zip Code *Contact Phone Number Contact Fax Number *Contact Email address Restaurant website address Current Insurance Carrier, if none, type "NONE" Current policy expiration date Current expiring premium *Number of years under current ownership *Number of years at current location *Please provide the annual sales for food and liquor, respectively, for the last 3 years.
*How many full-time employees? *How many part-time employees? *How many full-time and part-time bartenders, respectively? *How many full-time and part-time servers, respectively? *What is the average clientele age? *Currently opened for business? If not currently open, please advise why and approximate open date. *Is the property currently for sale? *Is the operation seasonal? If yes, advise # of days open. *Is Property vacant, foreclosed or undergoing renovation? *Is Property in deteriorating condition? *Distance to Ocean/Bay/Gulf/Intercoastal? *Is parking lot under your control? *How many square feet is the parking lot? *Building's age *Is the building sprinklered? *What dates where the follwing buidling elements updated?
*Do you own or lease the premises?
Own
Lease
Both
*What are the operating hours? *What is the total square footage of the facility? *What is the total square footage for the customers area only? *Any apartments owned by the business on the premises? If yes, how many? *Are your facilites ever rented out? If yes, how many times per year? *Central Station Burglar Alarm? *Fire Alarm? *Are owners active in this business? *Years of experience *Has the applicant ever filed for personal or business related bankruptcy? *Has insurance ever been cancelled due to non-pay within the last 3 years? *Is this operation a
Sports Bar
Bottle Club
Night Club
Private Club
None of the above
*Is cooking done with either
deep fat fryers
open flame
none of the above
*Does applicant have an Automatic Suppression System? *is there an active service contract? *How often is the automatic suppression system serviced and cleaned? *How often are the hoods/ducts serviced and cleaned? *Does the suppression system protect all Hoods, Ducts & Griddles? *Does the suppression system have an automatic fuel shut-off device? *Do the deep fat fryers have an automatic high limit shutoff? *Is there table-side cooking? *Are open bar-b-que pits used? *Any raw seafood served? If yes, please explain *Any firearms on the premises? *Any valet parking? *Any history of rowdiness or fights? *Is the premises located in the following locations:
airport
bowling alley
skating rink
roller rink
wharf
pier
beach
dock
piling
none of the above
*Does your premises allow patrons to enter a basement area or a floor below ground level? If yes, how many exits are there for each level and what is the width of stairs and exits for each?
*What is the maximum occupancy of the premises? *Is it posted? *Are the exits clearly marked? *Do the exits have emergency lighting? *Are any of the following found on the premises:
pool table
dart board
video games
volleyball
gambling machines
mechanical bulls
karoake
playrooms
playgrounds
none of the above
*Is there any live entertainment on the premises? If yes, describe what kind and how often?
*Are any bouncers or security guards used? *Are I.D. Checkers used? *Is there a dance floor? If yes, advise how many square feet and what kind of dancing? *Does this establishment employ female or male dancers? *Does this establishment have any
promotional nights
happy hour
ladies night
other type of entertainment
none of the above
If answered other than "none of the above", please explain:
Is this risk a catering establishment or a banquet hall? *Any off-premises catering? If yes, please explain:
What are the catering receipts percentage in relationship to total receipts? *Any delivery operations currently taking place? *Do you allow "Bring Your Own Beverage- BYOB? *Any prior losses in the last 3 years? If yes, please explain:
*Any incidents involving Assault & Battery occured in the past 3 years? If yes, please explain:
*Liquor License Held
Beer/Wine
Liquor
Both
None
If liquor license, is liquor served beyond 2 am? If liquor license is held, advise training for owners, managers & employees. Also descrine all liquor losses or violations in last 3 years. Advise if servers received certifed training.

* indicates a required field.

Disclaimer Notice - The premiums quoted are estimates based on information you provided. This quotation does not constitute a contract of insurance, nor does it provide coverage for any loss or claim. Coverage can only be bound by an agent with a signed application and a down payment.

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